肺动脉置管溶栓治疗急性肺栓塞

Catheter-directed thrombolysis for acute pulmonary embolism

目的探讨肺动脉置管溶栓治疗急性肺栓塞的疗效。方法 24例确诊为大面积或次大面积肺栓塞患者行下腔静脉滤器植入+肺动脉置管溶栓术。结果手术成功率100%,术后患者症状均有所缓解,术后第一天血氧饱和度(Sp O2)、心率、呼吸频率、收缩压、氧分压(PO2)、休克指数均较术前有明显改善(P<0.01)。影像学复查结果:14例(58.3%)血栓全部溶解,10例(41.7%)部分溶解。术后无严重并发症发生,死亡率为0。结论肺动脉置管溶栓起效迅速、局部溶栓效果强、并发症少。

Objective To investigate the efficacy of catheter-directed thrombolysis for acute pulmonary embolism.Methods Twenty-four patients with massive or submassive acute pulmonary embolism were treated by inferior vena cava filter implantation and pulmonary artery catheter-directed thrombolysis.Results The operative success rate was 100%. The clinical symptoms were relieved in all patients. SPO2, heart rate, respiration rate, systolic pressure, PO2 and shock index were significantly improved after operation(P < 0.01). Imaging review found that thrombus was completely dissolved in 14 cases(58.3%)and partly dissolved in 10 cases(41.7%). No severe postoperative complications occurred and the mortality rate was 0.Conclusion Catheter-directed thrombolysis has rapid onset, strong local thrombolytic effect and lower complications.